The progressive hair loss that affects many men and women as they get older is referred to medically as pattern hair loss, but the terms androgenetic alopecia (AGA) or female pattern hair loss (FPHL) may also be used. Other forms of hair loss include telogen effluvium (which is particularly common following pregnancy) and alopecia areata.
The signs and symptoms of hair loss vary according to the nature of the condition experienced, and in some instances whether the affected person is male or female.
Regardless of the form of hair loss experienced, many affected people (especially women, children and teens) find that it affects their quality of life and has emotional consequences such as psychological distress, reduced self-esteem and lowered moods.
Sometimes referred to as androgenetic alopecia (AGA), pattern hair loss involves the progressive thinning of the hair, and is the most common type of hair loss in both men and women. It takes its name from the distinctive patterns in which hair loss occurs, which tend to differ according to sex.
Up to 50% of men experience some degree of pattern hair loss by the time they reach their 50s, with a significant percentage ultimately becoming partially or completely bald.
In most cases, a receding hairline is the first sign of pattern hair loss in men. Thinning of the hair on the sides and top of the head may then occur, ultimately resulting in the formation of a bald patch when the areas join up. The hair on the occipital region at the lower rear of the scalp is usually the last to be affected.
Pattern hair loss tends to develop at a later age in women, with the incidence increasing after menopause. Up to 40% of women in their 70s experience it to some degree.
Compared to men, women with pattern hair loss are less likely to experience a receding hairline or become bald, and instead tend to experience a general, diffuse thinning of the hair, most significantly towards the front of the scalp and on the crown of the head.
The term telogen effluvium (TE) describes sudden diffuse hair loss and shedding that occurs in a generalised fashion across the scalp (rather than in the defined patterns of pattern hair loss or the small patches of alopecia areata) at rates significantly greater than the usual 30-150 strands per day. It is particularly common after pregnancy.
There are usually no symptoms other than noticing larger amounts of hair than usual in your hairbrush, comb or shower drain, or on your pillow in the mornings.
The loss typically occurs over a period of at least three months (but may persist for longer), resulting in the hair declining in volume.
The hair usually starts growing again after 3-6 months, but may take significantly longer than that to return to its previous volume.
In some people, telogen effluvium can aggravate or trigger the onset of pattern hair loss.
Alopecia areata is a form of hair loss in which hair is rapidly lost from one or more circular or oval coin-sized patches, and is discussed in more detail on this page.
Under normal circumstances, the hairs on your scalp undergo a continual process in which each individual strand moves through a cycle of being in a growth phase (called the anagen phase), a transition (catagen) phase and a period of resting and being shed (telogen phase). Issues with hair loss arise when this cycle is disturbed or compromised in some way.
From the perspective of traditional Chinese medicine (TCM), the health of the hair follicles and scalp are governed by the Kidney and Liver organ-meridians, which respectively direct Kidney Essence (also known as Jing) and Liver Blood to those tissues to provide nourishment and promote vitality and hair growth.
The tissue around the bulb of the hair is rich in receptors for androgens (male hormones such as testosterone), which are key drivers of hair growth and hair loss, and are present in the bodies of both men and women.
In pattern baldness, genetic factors lead the hair follicles of susceptible people to become more sensitive to a potent form of testosterone called dihydrotestosterone (DHT), which is formed by the actions of an enzyme called 5-alpha-reductase on testosterone.
This seems to occur because predisposed people have an increased concentration of 5-alpha-reductase and/or greater numbers of androgen receptors than other people.
This increases the impact of DHT on the hair follicle and appears to affect genes that would normally regulate the hair cycle, triggering the release of chemicals that promote the shedding (telogen) phase of the hair growth cycle, and causing the growth (anagen) phase of the cycle to become shorter.
With a limited timeframe in which to grow before moving into the telogen phase, the hairs lighten in colour and become smaller and finer (miniaturised), until they eventually fall out easily and the volume of hair progressively becomes sparser.
Eventually, the affected follicles no longer produce new hairs.
Regardless of whether it affects men or women, the distinctive patterns seen in this form of hair loss reflect the varying numbers of androgen receptors in the hair follicles in different parts of the scalp. In men, the follicles at the lower rear and sides of the head have fewer androgen receptors than those at the front, resulting in the characteristic monk-like appearance of the hair that often occurs. In women, the hairline rarely recedes because the hair follicles at the frontal hairline are less susceptible to the effects of DHT.
No cause can be found in up to 30% of cases of telogen effluvium.
In the remainder, its initiation can be traced to a trigger that occurred 2-4 months prior to the onset of the hair loss. Typical triggers include stress, febrile illness (an illness accompanied by a fever), dietary changes (e.g. crash dieting) or hormonal changes (e.g. childbirth, or under- or over-activity of the thyroid).
Under normal circumstances, only around 5-10% of the hairs on the scalp are in the telogen or shedding phase of the hair growth cycle. However, in telogen effluvium this alters rapidly a few months after the trigger has occurred, with 20-50% of hairs entering the telogen phase and being shed over a period of around three months.
It is believed that substances present in the body during times of stress may contribute to this process by inhibiting hair growth and encouraging hairs to shift out of the anagen (growth) phase and commence the transition to the telogen phase.
Most women experience telogen effluvium after giving birth, and while this can be confronting, it is nothing to be alarmed about.
The shedding occurs because the normal hair growth cycle pauses during pregnancy. As a result, normal hair losses cease, often causing the hair to look particularly full and healthy at this time.
Around nine weeks after the baby is born, the accumulated strands of hair start moving into the telogen (shedding) phase of the hair cycle and falling out. The hair loss may continue for 6-24 weeks, but the whole head of hair is usually replaced after several months.
The Chinese herb Fallopia has traditionally been used to aid the management of many forms of hair loss, including male and female pattern baldness, telogen effluvium, alopecia areata and general thinning of the hair, (including the hair loss that occurs during menopause).
From the perspective of traditional Chinese medicine (TCM), Fallopia works by strengthening and replenishing the Liver and Kidney organ-meridian systems, which are responsible for the growth and development of the hair. This in turn promotes healthy hair follicle function, with benefits for the volume, strength, colour and general condition of the hair.
In scientific terms, Fallopia may work by revitalising and reactivating hair follicles in the resting (telogen) phase of the hair growth cycle, and increasing the percentage of follicles in the growth (anagen) phase of the cycle.
It may also inhibit the enzyme 5-alpha-reductase, thereby reducing the effects of excess DHT, which contributes to male and female pattern baldness by causing hair follicles to shrink and waste away.
We recommend taking Fallopia as Phytofol®, a proprietary extract exclusive to Fusion® Health that’s specially formulated for optimal results and is best used in combination with other herbs and nutrients that support healthy hair.
(If you’re breastfeeding, Fallopia may not be the best choice for you. Instead we recommend taking a blend of herbs traditionally used to support healthy female reproductive function in addition to helping to manage hair loss, ideally alongside herbs traditionally taken to support the functioning of the Kidney organ-meridian system).
In TCM, Fallopia (Phytofol®) is rarely used alone, and is often taken alongside other herbs that support the Liver and Kidney organ-meridians and invigorate the Blood and circulation. Examples include White Peony, Cuscuta, Ligusticum, Dong Quai, Psoralea, Chinese Licorice, and Rehmannia.
Together with Fallopia, these herbs may help to restore poor or declining hair condition, and aid the management of thinning hair and hair that is weak, dry, brittle or dull.
Zinc is important for the health, growth and condition of the hair.
It may also aid the management of male and female pattern hair loss by helping to inhibit the enzyme enzyme 5-alpha-reductase, and consequently the effects of DHT.
When choosing a supplement, be aware that some forms of zinc are more readily absorbed than others. At Fusion® Health we recommend zinc glycinate (Optichel™ZN), which is easier for the body to absorb and utilise than many other forms of zinc.
Other minerals that support the healthy growth and appearance of the hair include silica, manganese, copper, selenium and iodine, which contribute to the hair's colour, volume, strength, shine and general condition.